We know that directions for some medications can be confusing, but a letter from two doctors and other two health-care professionals to the New England Journal of Medicine warns that the instructions for giving children the flu medication Tamiflu could result in serious dosing errors. One of the letter writers is the parent of a 6-year-old for whom Tamiflu, made by Roche Holding, was prescribed. The parents — the other is a primary-care physician — said they had “great difficulty” determining the correct dose to give their child despite their training. That’s because a syringe in the Tamiflu package comes with markings in milligrams, while the measurement dictated by the physician in this case used milliliters. The parents eventually figured out the correct dose by way of a mathematical formula they came up with

to convert the measurements on the label to the markings on the syringe. “Most families and caregivers would not be able to identify or perform the cumbersome calculations required to administer Tamiflu safely to children,” the authors warn in the letter appearing in the NEJM. They say there is a high chance for dosing errors, compromised treatment or toxic effects. The authors call for an immediate change to the instructions and packaging. The CDC, in a nod to the possible confusion, posted a note on its flu Web site today warning health-care professionals of the issue. A spokeswoman for Roche said it is working with the FDA to alert physicians to the prescribing issue. . Photo: Associated Press

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Measurement Confusion: Figuring the Right Dose for Tamiflu